机器人辅助单髁膝关节置换术的历史与未来

摘要：Robotic-assisted orthopedic surgery has been introduced to improve the accuracy of preoperative planning, operative bone cuts, component implantation position, and soft tissue balance in unicompartmental knee arthroplasty ( UKA ), with the expectation of improvement in implant durability and survivorship. Currently, roughly one-fifth of UKAs in the US are being performed with robotic assistance, and it is anticipated that there will be a substantial growth in market penetration of robotics over the next decade. First-generation robotic technology improved substantially implant position accuracy compared to conventional methods; however, high capital costs, uncertainty regarding the value of advanced technologies, and the need for preoperative computed tomography ( CT ) scans are barriers to its broader adoption. Newer image-free robotic-assisted orthopedic surgery optimizes both implant position accuracy and soft tissue balance, without the need for preoperative CT scans. Its portability makes it suitable for the application in an ambulatory surgery center, where approximately 40％ of these systems are currently being utilized. There are a few reports about clinical outcomes and long-term follow-up results, however, it remains unknown whether more accurate component position brings better clinical effects or better long-term survival rate of the implants. This article will review the robotic experience for UKA, including history, rationale, system descriptions, outcomes and future innovations.